How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $446.68 | Facility | None | $251.19 | $251.19 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $257.04 | Professional | None | $245.47 | $251.19 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $870.96 | Facility | None | $269.15 | $426.58 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $331.13 | Professional | None | $151.36 | $257.04 | $331.13 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $257.04 Typical High $371.54 | Facility | None | $77.62 | $257.04 | $371.54 |
Blue Shield Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $354.81 | Professional | None | $251.19 | $251.19 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $512.86 Typical High $776.25 | Facility | None | $257.04 | $512.86 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $831.76 | Professional | None | $407.38 | $630.96 | $831.76 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $263.03 Typical High $676.08 | Facility | None | $112.20 | $263.03 | $676.08 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | None | $245.47 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $776.25 | Facility | None | $257.04 | $257.04 | $776.25 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $512.86 | Professional | None | $100.00 | $251.19 | $512.86 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $125.89 Typical High $128.82 | Professional | 52 · Reduced service | $123.03 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $48.98 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $25.70 |
Where California sits
The same service costs 4.1 times more in Alaska than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
California· 17th of 51
$257
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.